question

Parents of 4 years old girl tell the kid about pass away grandparent.What is the action of RN to observe if the child has disfunctional grieving

1) She always hits the dolls

2) She does not want to sleep by herself at night

3) She keep saying grandparent come

4) She ask to play with grandparent

Which is the right answer????

Option 1. Always hitting the dolls would communicate anger. Eliminate this one, as it does not relate directly to dysfunctional grieving.

Option 2. Numerous 4 year-olds don't want to sleep by themselves at night. Eliminate this option, as it doesn't relate to dysfunctional grieving.

Option 3. This answer indicates the 4 year-old has not yet grasped the reality that the grandparent is dead. Consider this option.

Option 4. If she's asking to play with the grandparent, this may indicate dysfunctional grieving. Consider this option.

We're down to options 3 and 4. Since play is the universal language of children, I am going to select option 4 as the answer that I currently believe to be the best response.

Option 1. Always hitting the dolls would communicate anger. Eliminate this one, as it does not relate directly to dysfunctional grieving.

Hate these type of questions..... when I look at these questions think of "4 year old norms".

They:

may not like to sleep alone--still get up at night

out of temper tantrum stage, so anger not usual

usually inquisitive with lots of play and fantasy

understand concept: child, parent, grandparent

no experience with loss = death; if they loose a toy, usually find it again; family/friends come back to see them etc

So always hitting dolls = communicating anger

but sign not coping well = dysfunctional grief would be my choice

Another thing to look for in these questions "Always, sometimes, occasionally, never" Always hitting dolls = BINGO answer.